从《黄帝内经》气化理论探析伤寒六经实质与传经

Analysis on Essence of Six Meridians of Cold Pathogenic Disease and Meridian Transmission from Perspective of Qi Transformation in Inner Canon of Huangdi

伤寒“日传一经,七日复传”自古以来备受争议。通过分析《黄帝内经·素问》中运气七篇大论和《伤寒论》原文,综合历代医家和后世学者的说法,从气化的角度论述伤寒六经实质,肯定了伤寒之邪“日传一经,七日复传”理论的合理性,阐明伤寒之邪日传一经乃经表之传经,非在里脏腑之间的传经。因其经表之传经为日传一经,即按照“一日太阳、二日阳明、三日少阳、四日太阴、五日少阴、六日厥阴”之次序,所以其自经表传入本脏、本腑的天数亦有同步之趋势。其临床价值在于对外感疾病的判断、预后、远程诊断以及处方用药有较大的辅助作用。伤寒传经另有诸多晦暗不明之处,此篇不尽,略举其要。

“One meridian transmission a day,resuming on the seventh day”of cold pathogenic disease has been controversial since ancient times.By analyzing the seven great treatises on circuit and qi in Inner Canon of Huangdi·Plain Questions and the original text of Treatise on Cold Pathogenic Disease,as well as synthesizing the statements of the past generations of physicians and later scholars,the author discussed the essence of the six meridians of cold pathogenic disease from the perspective of qi transformation,and affirmed that the theory of“one meridian transmission a day,resuming on the seventh day”in cold pathogenic disease is reasonable.It is clarified that one meridian transmission a day runs on the exterior of meridians rather than zang-fu organs in the interior.Meridian transmissions on the exterior of meridians transmit one meridian a day which follow the order of“the first day Taiyang,the second day Yangming,the third day Shaoyang,the fourth day Taiyin,the fifth day Shaoyin,the sixth day Jueyin”,so the number of days transmitted from the exterior of meridians into zang-fu organs also tends to be synchronized.Its clinical value has a great auxiliary effect in the judgment,prognosis,remote diagnosis and medication of exogenous diseases.There are many other obscurities in meridian transmission of cold pathogenic disease which were introduced briefly in this paper.